An inexpensive, easy, and anatomically similar pericardiocentesis model manufacturing method using gelatin

Objective@#Cardiac tamponade with hemodynamic collapse requires immediate treatment, and ultrasound-guided pericardiocentesis is the treatment of choice. Although an essential skill for emergency physicians, there is a lack of training. We created a phantom that could practice ultrasound-guided pericardiocentesis using readily available materials. The pros and cons of the materials used were then compared. @*Methods@#Cardiac tamponade phantoms were made from gelatin, and included a heart, liver, and rib cage. We conducted a model-specific satisfaction questionnaire targeting 15 emergency physicians. The questionnaire was designed to be answered on a Likert 5-point scale. @*Results@#Creating the gelatin model took 6 hours. At room temperature, the gelatin model was able to retain its shape for 3 days. Fifteen physicians participated in the questionnaire, comprising five subjects having actual pericardiocentesis experience. In the questionnaire, our model achieved high satisfaction with all questions. @*Conclusion@#In our study, the pericardiocentesis phantom made from gelatin could maintain its shape for a long time, there was better recognition of the needle tip, and the model was more similar to the actual cardiac tamponade situation. Considering these positive characteristics, we recommend the phantom as a model for pericardiocentesis training.

Actual sweating as a significant predict factor of acute coronary syndrome

Objective@#This study aims to identify significant factors such as sweat that can be used as important predictors of acute coronary syndrome (ACS) in patients visiting the emergency department (ED) complaining of chest pain. @*Methods@#This observational, retrospective, registry-based study conducted from May 2020 to November 2020 evaluated patients who visited the ED due to chest pain. Parameters associated with ACS were investigated, and the clinical characteristics and symptoms were analyzed. @*Results@#A total of 230 patients visited the ED with chest pain. Of these, 94 (40.9%) were diagnosed with ACS. Univariate regression analysis showed that facial sweating (odds ratio [OR], 2.624; 95% confidence interval [CI], 1.241-5.549; P=0.012) and drench sweating (OR, 3.346; 95% CI, 1.602-6.991; P=0.001) were associated with ACS. Hence, we classified these patients as the actual sweating group. However, the sweaty feeling self-reported by patients with no visible sweat did not correlate with ACS. Multivariate logistic regression analysis showed that age (OR, 1.043; 95% CI, 1.016-1.071; P=0.002), quantum of smoking (OR, 1.023; 95% CI, 1.005-1.041; P=0.010), diastolic blood pressure (OR, 1.028; 95% CI, 1.004-1.049; P=0.009), squeezing chest pain (OR, 2.128; 95% CI, 1.000-4.531; P=0.050), and actual sweating (OR, 2.300; 95% CI, 1.209-4.374; P=0.011) were significantly associated with ACS. @*Conclusion@#Age, the quantum of smoking, diastolic blood pressure, squeezing chest pain, and actual sweating are useful predictors for ACS diagnosis. Unlike actual sweating, patient-reported sweating is not significantly related to the diagnosis of ACS. The results of this study will be beneficial in predicting ACS to ensure early and emergency medical care in the pre-hospital setting.

Clinically Significant Monocyte Biomarker for Differential Diagnosis of COVID-19 Pneumonia in the Emergency Department / 계명의대학술지

Objectives@#To determine basic patient characteristics and biomarkers to help in the early diagnosis of Coronavirus disease 2019 (COVID-19) pneumonia in patients with pneumonia who visited the emergency department (ED). @*Methods@#This retrospective study evaluated patients diagnosed with community-acquired pneumonia (CAP) or COVID-19 pneumonia in ED at four tertiary medical centers between February 1 and March 31, 2020. Parameters related to the differential diagnosis between CAP and COVID-19 were investigated. Clinical characteristics and laboratory results of biomarkers were analyzed. @*Results@#In total, 81 patients presented to the ED with COVID-19 pneumonia. Multivariate logistic regression analysis showed that monocyte count [odds ratio (OR): 0.996; 95% confidence interval (CI): 0.994–0.999] and pneumonia severity index (PSI) [OR: 1.025; 95% CI: 1.002–1.049] were associated with diagnosis of COVID-19 pneumonia. The area under the curve comprising the combination of monocyte and PSI was 0.789. @*Conclusion@#Differential diagnosis of COVID-19 pneumonia from pneumonia patients who visited the emergency room can be made by monocyte count and PSI score.

Suicide Attempt by Inhalation of Argon Gas / 계명의대학술지

Suicide attempts using asphyxiants have been increasing compared to the past. Argon is an inert gases which is harmless to the human body, but when inhaled, can causes suffocation due to lack of oxygen. A 24-year-old man was admitted to the emergency department after an attempted suicide using argon gas. At the time of arrival, his mental status was drowsy and hematologic data indicated lactic acidosis. Consciousness was recovered after 3 hours and he was discharged without complications. He stated that he had discovered about argon gas through a suicide website and proceeded to make his purchase online. Nowadays, such websites with information on suicides are exposed to the general public without discretion and has become a major social issue. Therefore, although current suicide rates using argon gas are low in Korea, it is a suicide method to take note of in the future.

Correlation between the size of the ureter stone and the neutrophil-lymphocyte ratio, platelet lymphocyte ratio, and C-reactive protein in patients with ureter stone visiting the emergency department

Objective@#The size and location of ureter stones are important factors in their spontaneous passage. We compared the clinical characteristics and neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and C-reactive protein (CRP) of patients who visited the emergency department with ureter stones of ≥5 mm and <5 mm in size. @*Methods@#We retrospectively reviewed 699 patients who visited the emergency department of two medical centers from January 2017 to December 2019. We compared microscopic hematuria, pyuria, NLR, PLR, CRP, the grade of hydronephrosis, and the location of ureteral calculi between the two groups. @*Results@#There were 419 patients with ureter stones less than 5 mm and 280 patients with stones more than 5 mm in size. NLR was 2.82 (1.44-4.73) and 3.12 (1.94-5.75) in patients with stones <5 mm and ≥5 mm, respectively (P=0.001). PLR was 117.2 (88.2-164.9) and 136.0 (98.9-199.7) in patients with stones <5 mm and ≥5 mm, respectively (P=0.001). CRP was 0.29 (0.29-0.29) and 0.29 (0.29-1.04) in patients with stones <5 mm and ≥5 mm, respectively (P<0.001). The proportion of microscopic hematuria was 84.7% and 76.4% in patients with stones <5 mm and ≥5 mm, respectively (P=0.006). The proportion of pyuria was 20.5% and 41.8% in patients with stones <5 mm and ≥5 mm, respectively (P=0.01). @*Conclusion@#In patients with ureter stones ≥5 mm, CRP, NLR, and PLR were significantly higher than patients with ureter stones <5 mm. However, further studies are needed before using these indicators to make clinical decisions regarding ureteral stone management.

Clinically Significant Monocyte Biomarker for Differential Diagnosis of COVID-19 Pneumonia in the Emergency Department / 계명의대학술지

Objectives@#To determine basic patient characteristics and biomarkers to help in the early diagnosis of Coronavirus disease 2019 (COVID-19) pneumonia in patients with pneumonia who visited the emergency department (ED). @*Methods@#This retrospective study evaluated patients diagnosed with community-acquired pneumonia (CAP) or COVID-19 pneumonia in ED at four tertiary medical centers between February 1 and March 31, 2020. Parameters related to the differential diagnosis between CAP and COVID-19 were investigated. Clinical characteristics and laboratory results of biomarkers were analyzed. @*Results@#In total, 81 patients presented to the ED with COVID-19 pneumonia. Multivariate logistic regression analysis showed that monocyte count [odds ratio (OR): 0.996; 95% confidence interval (CI): 0.994–0.999] and pneumonia severity index (PSI) [OR: 1.025; 95% CI: 1.002–1.049] were associated with diagnosis of COVID-19 pneumonia. The area under the curve comprising the combination of monocyte and PSI was 0.789. @*Conclusion@#Differential diagnosis of COVID-19 pneumonia from pneumonia patients who visited the emergency room can be made by monocyte count and PSI score.

Suicide Attempt by Inhalation of Argon Gas / 계명의대학술지

Suicide attempts using asphyxiants have been increasing compared to the past. Argon is an inert gases which is harmless to the human body, but when inhaled, can causes suffocation due to lack of oxygen. A 24-year-old man was admitted to the emergency department after an attempted suicide using argon gas. At the time of arrival, his mental status was drowsy and hematologic data indicated lactic acidosis. Consciousness was recovered after 3 hours and he was discharged without complications. He stated that he had discovered about argon gas through a suicide website and proceeded to make his purchase online. Nowadays, such websites with information on suicides are exposed to the general public without discretion and has become a major social issue. Therefore, although current suicide rates using argon gas are low in Korea, it is a suicide method to take note of in the future.

Predicting Factors Associated with Large Amounts of Glyphosate Intoxication in the Early-Stage Emergency Department: QTc Interval Prolongation

Purpose@#Taking large amounts of glyphosate is life-threatening, but the amounts of glyphosate taken by patients for suicide are not known precisely. The purpose of this study was to find the predictors of large amounts of glyphosate ingestion. @*Methods@#This retrospective study analyzed patients presenting to an emergency department with glyphosate intoxication between 2010 and 2019, in a single tertiary hospital. The variables associated with the intake amounts were investigated. The parameters were analyzed by multivariate variate logistic regression analyses and the receiver operating characteristic (ROC) curve. @*Results@#Of the 28 patients with glyphosate intoxication, 15 (53.6%) were in the large amounts group. Univariate analysis showed that metabolic acidosis, lactic acid, and corrected QT (QTc) interval were significant factors. In contrast, multivariate analysis presented the QTc interval as the only independent factor with intoxication from large amounts of glyphosate. (odds ratio, 95% confidence interval: 1.073, 1.011-1.139; p=0.020) The area under the ROC curve of the QTc interval was 0.838. @*Conclusion@#The QTc interval is associated significantly with patients who visit the emergency department after being intoxicated by large amounts of glyphosate. These conclusions will help in the initial triage of patients with glyphosate intoxication.

Predicting Factors Associated with Large Amounts of Glyphosate Intoxication in the Early-Stage Emergency Department: QTc Interval Prolongation

Purpose@#Taking large amounts of glyphosate is life-threatening, but the amounts of glyphosate taken by patients for suicide are not known precisely. The purpose of this study was to find the predictors of large amounts of glyphosate ingestion. @*Methods@#This retrospective study analyzed patients presenting to an emergency department with glyphosate intoxication between 2010 and 2019, in a single tertiary hospital. The variables associated with the intake amounts were investigated. The parameters were analyzed by multivariate variate logistic regression analyses and the receiver operating characteristic (ROC) curve. @*Results@#Of the 28 patients with glyphosate intoxication, 15 (53.6%) were in the large amounts group. Univariate analysis showed that metabolic acidosis, lactic acid, and corrected QT (QTc) interval were significant factors. In contrast, multivariate analysis presented the QTc interval as the only independent factor with intoxication from large amounts of glyphosate. (odds ratio, 95% confidence interval: 1.073, 1.011-1.139; p=0.020) The area under the ROC curve of the QTc interval was 0.838. @*Conclusion@#The QTc interval is associated significantly with patients who visit the emergency department after being intoxicated by large amounts of glyphosate. These conclusions will help in the initial triage of patients with glyphosate intoxication.

Early coronary angiography in patients with out-of-hospital cardiac arrestand improved survival discharge rate

Objective@#Coronary angiography (CAG) is an important procedure in post-resuscitated patients with out of hospital cardiacarrest (OHCA). On the other hand, the timing of CAG is still controversial. This study investigated the relationshipbetween electrocardiogram, cardiac enzyme, echocardiographic findings, and early coronary angiography (ECAG). @*Methods@#The medical records of OHCA patients from January 2014 to December 2018 were reviewed retrospectively.The total patients who underwent CAG for OHCA caused by cardiac origin were 48. They were divided into two groupsaccording to survival discharge. The ECAG was defined as the time from reporting 119 to the CAG within two hours. Thefollowing items in the two groups were also analyzed: the prehospital factors, such as witnessed arrest, bystander cardiopulmonaryresuscitation, shockable rhythm, and arrest to return of spontaneous circulation time; and the hospital factors,such as the timing of CAG, ST-segment elevation or depression in the electrocardiogram, troponin-I elevation, andtransthoracic echocardiography findings. @*Results@#Twenty-seven patients out of 48 patients with OHCA (56.3%) underwent ECAG. In the survival group (n=35),ECAG incidence was significantly higher than the death group (n=24 [68.6%] vs. n=3 [23.1%], P=0.008) and the adjustedodds ratio of ECAG for predicting survival discharge was 10.69 (95% confidence interval, 1.7-68.8). @*Conclusion@#In this retrospective study, the patients applied with ECAG showed a better prognosis in the survival dischargerate than the patients with delayed CAG.

A Comparative Study on the Clinical Features and Complications of Snake Bite Patients in Urban and Rural Areas / 農村醫學 地域保健

Purpose@#The purpose of this study is to compare the clinical features and complications of snake bite patients in urban and rural areas. @*Methods@#A retrospective study was conducted on patients over 18 years of age who were hospitalized for snake bites from January 2013 to December 2019. Patients were categorized into urban and rural groups according to their respective locations at the time of the snake bite and the clinical characteristics and complications of the two patient groups were researched and compared. @*Results@#Of the 77 snake bite patients, 44 patients were categorized into the rural group (57.1%). The rura1 group showed significant differences in old age (p=0.011), delayed hospital visits (p=0.010), far hospital distance (p<0.001), high local effect score (p<0.001), high traditional snake-bite severity grading scale (p=0.008) and use of large amounts of antivenins (p=0.026). There was a significantly higher incidence of acute kidney injury (p=0.030), rhabdomyolysis (p=0.026), and coagulopathy (p=0.033) in the rural group as well as a longer hospitalization period (p<0.011). @*Conclusion@#Snake bites that occurred in rural areas resulted in patients with more complications compared to urban areas due to farther distances from hospitals, causing a delay in antivenom treatment.

Cardiac Tamponade Associated with Acupuncture / 계명의대학술지

Acupuncture is regarded as a relatively safe procedure, but it may have various complications. Cardiac tamponade after acupuncture is an extremely rare complication but can have fatal outcomes. We present a 73-year-old female patient with decreased consciousness and dyspnea after acupuncture at an oriental medical clinic. Initial vital signs were a blood pressure of 60/40 mmHg and a heart rate of 110 beats/min. Echocardiography and chest computed tomography were performed in the emergency department to determine the cause of the shock, and the result came out as hemopericardium. The patient underwent through an emergency cardiac surgery under the diagnosis of cardiac tamponade following acupuncture and was fully recovered after surgery.

Clinical significance of microscopic hematuria and hydronephrosis in ureteral calculi patients visiting emergency department

OBJECTIVE: This study examined the clinical significance of microscopic hematuria and grade of hydronephrosis in ureteral calculi patients visiting the emergency department (ED). METHODS: The EDs of two medical centers were reviewed retrospectively from August 1, 2012 to July 31, 2017. The total ureteral calculi patients were 2,069 and 1,593 patients were analyzed after exclusion. The normal range of microscopic hematuria in both medical centers was 0–5/high power field (HPF) of red blood cell in urinalysis. Therefore, microscopic hematuria more than 5/HPF was defined as positive. The size of the stone, grade of hydronephrosis (normal, mild, moderate, and severe) and location of ureteral calculi in the non-contrast abdomen and pelvis computed tomography (CT) was measured by one person at each medical center using same method. The patients with or without microscopic hematuria and grade of hydronephrosis were then compared. RESULTS: The median size of the ureteral calculi patients without and with microscopic hematuria was 5.4 mm (range, 3.8–9.0 mm) and 4.0 mm (range, 3.0–5.8 mm) (P < 0.001). The patients grouped as normal to mild, and moderate to severe hydronephrosis, without microscopic hematuria was 191 (16.5%) and 91 (20.9%), respectively. On the other hand, microscopic hematuria was 966 (83.5%) and 345 (79.1%) (P=0.042). According to the location of ureteral calculi, with and without microscopic hematuria was 81.9% and 18.1% in the upper ureter, 82.9% and 17.1% in the mid ureter, and 82.6% and 17.4% in the lower ureter, respectively (P=0.935). CONCLUSION: The median size of the stone and grade of hydronephrosis were related to microscopic hematuria but the location of the ureteral calculi was not related. Therefore, in cases without microscopic hematuria in suspected ureteral calculi, clinicians should check the abdomen and pelvis CT for an accurate diagnosis and treatment of ureteral calculi.

Early Predictors of High-Flow Nasal Cannula Oxygen Therapy Failure in the Emergency Room / 계명의대학술지

High flow nasal cannula (HFNC) oxygen therapy has become a substitute for other non-invasive ventilation (NIV) and mechanical ventilation in patients with respiratory failure. Despite its strong points, HFNC may result in failure of therapy, and delayed intubation leads to poor patient outcomes. This study is aimed to identify the variables that predicts HFNC oxygen therapy failure in order to increment success rate and prevent delayed intubation. The study was conducted in a retrospective manner, enrolling all non-traumatic patients over the age 20 who visited a single university-affiliated tertiary medical center emergency room and were treated with HFNC between March 1, 2016 to Feburary 28, 2017. Patients were classified into two groups: HFNC success group, and HFNC failure group: HFNC failure group was defined as patients who were treated with HFNC, and resulted in intubation and mechanical ventilation, or death. General characteristics, clinical features, and laboratory findings of the two groups were compared. Additionally, univariable logistic regression was done for statistically significant variables, and if the p-value was < 0.05, multivariable logistic regression analysis was conducted. 95 patients were enrolled in the study. Repeated-measure ANOVA was conducted for serial arterial blood gas samples during therapy. 62 patients were successful in the treatment, and the treatment failed in 33 cases. After multivariate logistic regression analysis, variable that showed statistically significant association with HFNC failure was initial hematocrits (p < 0.05). Repeated-measure ANOVA revealed low bicarbonate as a predictor of HFNC failure. Predictors of HFNC therapy failure are initial hematocrits, bicarbonate levels during therapy.

The Effect and Applicability of Anatographic for Anatomy Education / 체질인류학회지

There are various methods for anatomy learning. Recently, there is infographics as a way to effectively transmit large amounts of data and complex information. In this way, medical students made anatomical data as ‘anatographic’. A total of 205 participants including 60 pre-medical students, 111 medical students, and 34 doctors participated in the study. We have shown an example of anatographic, and we surveyed its applicability and the satisfaction of each method. They use textbooks, Google, other searching sites, and applications for anatomy learning. The usefulness according to the 5-point scale was 3.75 for textbooks and 3.60 for Google, 2.53 for applications and 2.08 for searching sites, respectively. The utility of anatographic was 3.59, which was significantly higher than that of the application or other searching sites (p < 0.05). Anatographic is useful because of easy search for tags and questions, information share and learning from anywhere using your smartphone. On the other hand, there was the hassle of online access and the reliability of the data could be reduced for doctors to use. There was a problem that students used the smartphone outside of learning. Anatographic is the most beneficial system for the head, neck, and nerves, and it is easier to understand complex structures. Anatographic have shown potential as an educational source that can effectively transmit vast amounts of anatomical knowledge, and they will be useful for future anatomy education.

Variation of the Subscapular Artery According to Branching Pattern of the Axillary Artery / 체질인류학회지

The axillary artery (AA) is often referred to as having three parts, with these divisions based on its location relative to the pectoralis minor muscle. In third part, AA gives off the subscapular (SSA), anterior circumflex humeral, and posterior circumflex humeral arteries (PCHA). However, variations in these arteries were extremely diverse. So, we observed actually some branching patterns of these arteries in this study. METHOD: We studied the pattern of SSA in 128 upper limbs from donated cadavers. RESULT: SSA was originated directly from the third and second parts of AA in 37.5% (48/128) and 4.7% (6/128), respectively. A PCHA made a common trunk with SSA in 25.8% (33/128), and these trunks arose from the third and second parts of AA in 21.1% (27/128) and 4.7% (6/128), respectively. A lateral thoracic artery (LTA) arose from SSA in 12.5% (16/128), and these were originated from the third and second parts of AA in 4.7% (6/128) and 7.8% (10/128), respectively. In 19.5% (25/128) of upper limbs, LTA, SSA, and PCHA have a common trunk, and these arose from the third and second parts of AA in 12.5% (16/128) and 7.0% (9/128), respectively. According to the branching pattern of the SSA, its origin was significantly different.

What is the Clinical Significance of Initial Lactate Measurement Compared to Carboxyhemoglobin Measurement in Carbon Monoxide Poisoning?

PURPOSE: This study was performed to compare clinical significance between lactate and carboxyhemoglobin (COHb) in a patient with carbon monoxide (CO) poisoning. METHODS: We conducted a 13-year retrospective study on CO poisoning patients who visited the emergency departments of the Medical Center between October 2004 and January 2016. The patients were divided into two groups according to initial lactate levels. Patients with serum lactate levels of ≤2 mmol/L were classified as the normolactatemia group (n=14), and patients with serum lactate levels of >2 mmol/L were classified as the hyperlactatemia group (n=34). General characteristics, clinical features, and laboratory findings of the two groups were compared. In addition, we compared initial lactate levels with COHb levels according to complications, neurological disorder, myocardial enzyme elevation, and abnormal Glasgow Coma Scale (GCS) score in patients with CO poisoning. We also analyzed the correlation between laboratory parameters and lactate levels. RESULTS: Forty-eight patients were enrolled in this study. The hyperlactatemia group had significantly more neurological disorders and consciousness disorders than the normolactatemia group (p<0.001), and COHb, creatine phosphokinase MB, and troponin I levels were also significantly higher in the hyperlactatemia group (p<0.001, p=0.017, and p=0.007). Lactate levels were significantly elevated in patients with elevated cardiac enzymes (p=0.001), neurological disorders (p<0.001), complications (p=0.001), and abnormal GCS score (p<0.001), whereas COHb levels were not significantly increased in all subjects. The correlation between COHb and lactate levels was weak (r=0.313, p=0.030), and a positive correlation was found between lactate and bicarbonate (HCO3), white blood cell, and troponin I (p<0.001). The diagnostic value of lactate for severe CO poisoning was analyzed using a receiver operating characteristic curve. The optimal cut-off value of lactate was 2.2 mmol/L with 83.3% sensitivity and 91.7% specificity (p<0.001). CONCLUSION: Lactate has significant diagnostic efficacy in patients with CO poisoning. It is recommended that lactate level be measured for appropriate treatment and prognostic evaluation of CO poisoning.

Limitation of Psychiatric Intervention for Suicidal Drug Intoxication Patients in Emergency Room

PURPOSE: This study was designed to determine the factors hindering psychiatric intervention for suicide attempters in the emergency room (ER). METHODS: Participants were 299 patients aged 18 years or older admitted to the ER for suicidal drug overdose between July 2012 and June 2014. Patients were divided into two groups according to whether they had received psychiatric treatment in the ER. Medical histories and follow-up treatments were determined by examining patients' medical records and through phone surveys, and were then compared using χ2-test and Fisher's exact test. In addition, the rate of satisfaction of the treatment group and the reasons for their dissatisfaction were also determined. RESULTS: The treatment and non-treatment groups comprised 135 (45%) and 164 patients (55%), respectively. Factors influencing participation in psychiatric intervention were previous history of suicide attempts (p=0.004), history of psychiatric disorder (p<0.001), time of day (p=0.039), and day of the week (p=0.040) of arrival in the ER. Whether or not the patient received follow-up psychiatric treatment was not significantly relevant (p=0.300). Of the 82 patients who participated in the treatment satisfaction survey, 50.2% reported being unsatisfied, mainly because of unfriendly medical personnel (36.6%), discomfort regarding other people's perceptions (24.4%), and cursory care (14.6%). CONCLUSION: To raise the participation rate of psychiatric consult, cooperation with psychiatry at night and on weekends is required, and incorporation of patients without previous history of suicidal attempt or other psychiatric disorder is important. Resolution of complaints toward psychiatric consult in suicide attempt survivors is also required.

Limitation of Psychiatric Intervention for Suicidal Drug Intoxication Patients in Emergency Room

PURPOSE: This study was designed to determine the factors hindering psychiatric intervention for suicide attempters in the emergency room (ER). METHODS: Participants were 299 patients aged 18 years or older admitted to the ER for suicidal drug overdose between July 2012 and June 2014. Patients were divided into two groups according to whether they had received psychiatric treatment in the ER. Medical histories and follow-up treatments were determined by examining patients' medical records and through phone surveys, and were then compared using χ2-test and Fisher's exact test. In addition, the rate of satisfaction of the treatment group and the reasons for their dissatisfaction were also determined. RESULTS: The treatment and non-treatment groups comprised 135 (45%) and 164 patients (55%), respectively. Factors influencing participation in psychiatric intervention were previous history of suicide attempts (p=0.004), history of psychiatric disorder (p<0.001), time of day (p=0.039), and day of the week (p=0.040) of arrival in the ER. Whether or not the patient received follow-up psychiatric treatment was not significantly relevant (p=0.300). Of the 82 patients who participated in the treatment satisfaction survey, 50.2% reported being unsatisfied, mainly because of unfriendly medical personnel (36.6%), discomfort regarding other people's perceptions (24.4%), and cursory care (14.6%). CONCLUSION: To raise the participation rate of psychiatric consult, cooperation with psychiatry at night and on weekends is required, and incorporation of patients without previous history of suicidal attempt or other psychiatric disorder is important. Resolution of complaints toward psychiatric consult in suicide attempt survivors is also required.

In vitro Effects of Epigallocatechin Gallate on Sister Chromatid Exchange in the Lymphocytes Exposed to Glyphosate

PURPOSE: Green tea is known as a potent anti-oxidant, anti-carcinogen, and genetic protector. Glyphosate (N-phosphonomethyl glycine) is a widely used non-selective herbicide that causes DNA damage. The present study was conducted to investigate the protective effects of green tea in human blood lymphocytes exposed to glyphosate using the Sister Chromatid Exchange (SCE) frequency method. METHODS: Peripheral blood was obtained from 10 volunteers and cultured through four different conditions. Four groups were divided into control, glyphosate only (300 ng/mL), glyphosate and low (20 µm) concentrations of epigallocatechin gallate (EGCG) and glyphosate and high (100 µm) concentrations of EGCG. RESULTS: The glyphosate exposed groups had a higher mean SCE frequency (10.33±2.50) than the control group (6.38±2.28, p<0.001). The low concentrations of EGCG groups had a lower mean SCE frequency (9.91±1.93) than the glyphosate-only group, although this difference was not significant (p=0.219). However, the high concentration group (9.49±1.85) had a significantly lower SCE frequency than the glyphosate-only group (p=0.001). CONCLUSION: EGCG has a gene protective effect in human lymphocytes exposed to the genotoxicity of glyphosate in the case of high concentrations.